MHES provides update on HSA Governance Assessment

The Ministry of Health, Environment and Sustainability (MHES) is providing an update on the ongoing diagnostic assessment of the Health Services Authority (HSA), being conducted by KPMG, as part of its commitment to transparency and continuous improvement.

The assessment, which commenced in January 2026, is designed to support system-level improvements and advance national health priorities. It has progressed through key phases, including stakeholder engagement, data collection, and preliminary analysis.

Over the past 12 weeks, several critical steps have been completed. A structured framework was implemented to examine how the HSA operates, including its decision-making processes, organisational structure, and oversight mechanisms. This included a series of in-depth interviews conducted in February, generating extensive qualitative feedback.

To broaden participation, surveys were distributed across Grand Cayman, Cayman Brac, and Little Cayman in early March. A total of 686 individuals contributed, including HSA staff, external partners, and members of the public. This exceeded the initial participation target and reflects strong engagement across stakeholders.

Analysis of the survey responses and interviews identified key themes, including clarity of strategic direction, defined roles and responsibilities, performance monitoring, communication effectiveness, and levels of engagement and trust. Initial findings were presented by KPMG to the Ministry in April to support alignment on priority areas for further review.

Minister for Health, Environment and Sustainability, Katherine Ebanks-Wilks, said: “The Ministry commissioned this independent assessment to ensure that the HSA is operating effectively and in line with best practice. From the outset, we committed to a transparent process. The findings will be shared publicly, and we will outline the actions to be taken to address the issues identified.”

This process has included engagement across the HSA and the wider community, with input informing both the analysis and the development of recommendations.

KPMG Director Penny Barker said: “KPMG is proud to have supported the Ministry of Health, Environment, and Sustainability in advancing the diagnostic assessment of the governance, leadership, and effectiveness of the HSA. Efforts have centered on grounding the assessment in stakeholder engagement to support buy-in and effective implementation, with participation to date highly encouraging. We look forward to continuing our collaboration with the MHES as we finalize the report ahead of its publication.”

Chief Officer for Health, Environment and Sustainability, Tamara Ebanks, added: “The insights gathered provide a clear view of current strengths and areas for improvement, and will inform practical steps to enhance governance structures, clarify roles, and improve overall organisational performance.”

The final report is in progress, with a public press conference scheduled in June,  to present the findings and outline next steps. This forms part of the Ministry’s broader commitment to transparency, accountability, and high-performing public health services.

Further updates will be provided as the process concludes.